TENS for the Long-Term Treatment of Ocular Pain 2020

pattismith

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TENS for the Long-Term Treatment of Ocular Pain
Kristen Zayan BS, Shruti Aggarwal MD, Elizabeth Felix PhD, Roy Levitt MD, Konstantinos Sarantopoulos MD, PhD, Anat Galor MD, MPSH
First published: 20 March 2020

https://doi.org/10.1111/ner.13146

Meeting Presentation: This work has been presented at the American Society of Cataract and Refractive Surgeons annual meeting, San Diego 2019

Abstract

Purpose
Ocular pain is a debilitating condition that is challenging to treat as therapies that target the ocular surface are often ineffective.

We previously reported a short-term reduction in ocular pain after one periocular transcutaneous electrical nerve stimulation (TENS) session. The current study aims to elucidate the long-term effect of TENS on ocular pain.

Materials and Methods
Fourteen individuals with eye pain were identified as candidates for a TENS device (RS Medical, Vancouver) for home use after a successful trial in clinic between February 2018 and July 2019 at the Miami Veterans Administration Hospital or University of Miami. Ten of the 14 patients were included in this retrospective review, based on the inclusion of receiving and using the device for a minimum of three months. The median age of the ten patients was 47.5 years, range 32–73 years, and eight were male. The main outcome measures were 1) frequency of long-term integration of TENS into ocular pain management and 2) patient reported ocular pain intensity (0-10) pre- vs. post-treatment.

Results
Patients reported an initial median use of the device 14.0 times per week and over time reducing the frequency to 3.0 times per week.

All reported that the TENS unit was successfully incorporated into their ocular pain management routine for at least three months (median duration of use 6.5 months, range 3–14 months).
Nine of ten patients reported subjective pain reduction with use of the TENS device at home. Overall, pain intensity decreased by approximately 27.4% (mean rank = 5.6, Z = −2.1, p = 0.02) post- vs. pre-treatment. No adverse events associated with TENS were reported in any patient.

Conclusion
Our preliminary data suggest that TENS can be integrated into the long-term management of ocular pain with improvements in overall pain intensity.
 
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I wonder what ocular pain is?

Reading something like this- that is often my question. What are they describing? Can't they be more clear?

I wonder what it means to apply the Device to the eye. Also not explained.

can we obtain the device ?
 

pattismith

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I wonder what ocular pain is?

Reading something like this- that is often my question. What are they describing? Can't they be more clear?

I wonder what it means to apply the Device to the eye. Also not explained.

can we obtain the device ?
this is another paper by one of the author, it may explain more:


Long-Term Trigeminal Nerve Stimulation as a Treatment for Ocular Pain
Divy Mehra BS, Simran Mangwani-Mordani, Kelly Acuna BS, Jodi C. Hwang BS, Elizabeth R. Felix PhD, Anat Galor MD, MSPH
First published: 04 May 2021

https://doi.org/10.1111/ner.13402

Abstract

Objectives
Ocular pain symptoms (e.g., hypersensitivity to light and wind, “burning” sensations) can be debilitating and difficult to treat.
Neuromodulatory therapies targeting sensory trigeminal and central pain pathways may help treat chronic ocular pain refractory to traditional therapies. The current study evaluates the long-term effects of a trigeminal neurostimulator (TNS) on ocular pain.

Materials and Methods
Retrospective review of 18 individuals at the Miami Veterans Affairs Eye Clinic with chronic, severe ocular pain who were prescribed and used TNS at home for ≥3 months. The primary outcome measures were 1) ocular symptom intensity over a 24-hour recall period (dryness, pain, light sensitivity, wind sensitivity, burning; rated on 0–10 scales) captured pre-TNS and at monthly follow-up intervals and 2) side effects. The frequency and duration of TNS was a secondary outcome measure.

Results
The mean age of the population (n = 18) was 57.5 years (range, 34–85 years) with a male majority (67%). Two individuals discontinued use due to lack of efficacy and one due to confounding health issues. Initial mean weekly frequency of TNS use was 3.7 ± 1.9 sessions of 25.8 min at month 1 and 2.7 ± 2.3 sessions of 28.0 min at month 6. At six months, pain intensity (↓ 31.4%), light sensitivity (↓ 36.3%), wind sensitivity (↓ 32.6%), and burning sensation (↓ 53.9%) were all decreased compared to baseline (p < 0.01 for all); greater decreases in ocular pain were noted in individuals with migraine (n = 10) than those without migraine (n = 8). No significant change was noted in mean dryness scores. Fifteen subjects experienced sedation with TNS use, persisting throughout the follow-up visits. No other adverse effects were communicated by any subjects.

Conclusion
Our study suggests TNS is a safe, adjunctive treatment option in individuals with severe, chronic ocular pain. Individuals demonstrated gradual, continual improvement in pain symptoms over time within a multimodal approach.
 
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this is another paper by one of the author, it may explain more:
I can't imagine answering these types of somewhat subjective questions about eye symptoms- mine have a whole array of conditions that are so confounding.

But it did seem to help something- helped Burning- a nice symptom to have less of.
 

pattismith

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pattismith

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Last edited:
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Trigeminal was being discussed in another paper dealing with the previously believed to be psychosomatic symptom: BURNING TONGUE

My tongue is the road map to my illness body, its all displayed there, and burning is a common state.

But WHAT do they mean by burning tongue? A person posting the article responded to say: tongue being ripped off of a frozen can.

https://pubmed.ncbi.nlm.nih.gov/26847146/

so its another small fiber neuropathy....and no thanks, leave my tongue alone, its already fully occupied.
 

Judee

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here the trigeminal nerve, they apply TENS around the eye on these nerve branches
I'm glad you cleared that up with a visual because I was picturing they were putting those zappy things on the eyes or eye lids. Even on the eye lids, I would think that would also cause a lot of pain. Yikes! :nervous:
 

pattismith

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Trigeminal was being discussed in another paper dealing with the previously believed to be psychosomatic symptom: BURNING TONGUE

My tongue is the road map to my illness body, its all displayed there, and burning is a common state.

But WHAT do they mean by burning tongue? A person posting the article responded to say: tongue being ripped off of a frozen can.

https://pubmed.ncbi.nlm.nih.gov/26847146/

so its another small fiber neuropathy....and no thanks, leave my tongue alone, its already fully occupied.
I had transient burning tongue some years ago, and burning dry eyes are among my very first symptoms, 35 years ago.

(SFN is now confirmed with skin leg biopsy)

TENS doesn't fix the root of pain, but it can help manage it;

Things that are proposed to help with the root of corneal pain are in the article I posted earlier (AST and loteprednol drops...)

NEUROPATHIC CORNEAL PAIN: APPROACHES FOR MANAGEMENT 2017 | Phoenix Rising ME/CFS Forums

In this site, they propose TENS for burning mouth as well

Face pain — How to use a TENS machine (tensmachineinfo.com.au)
;;